Bioengineering platforms for precision respiratory rehabilitation: biomaterials, lung-mimetic models, and wearable biointerfaces

Pulmonary rehabilitation is an established intervention for chronic respiratory diseases, but heterogeneous responses, limited mechanistic resolution, and incomplete real-world monitoring restrict precision delivery. Bioengineering platforms may address these gaps by linking clinically actionable respiratory traits to biomaterials, lung-mimetic models, and wearable biointerfaces. This critical narrative Review examines how bioengineering platforms may address three complementary translational needs in precision respiratory rehabilitation: modulation of recovery-relevant pulmonary microenvironments, mechanistic and safety testing in human-relevant lung models, and continuous measurement of rehabilitation exposure and response. We organize these functions within a Trait–Material–Interface–Endpoint framework that links engineering-actionable traits to appropriate platforms, validation requirements, and patient-centred outcomes. The evidence base is uneven. Clinical benefits of pulmonary rehabilitation are well established, whereas direct evidence that biomaterials enhance rehabilitation outcomes remains limited, and many organ-on-chip and wearable applications are still at preclinical or validation stages. These technologies should therefore complement rather than replace guideline-based rehabilitation. Future studies should use staged safety testing, trait-based enrolment, validated digital measures, patient-centred functional outcomes, and implementation endpoints to determine whether bioengineering can make respiratory rehabilitation more measurable, personalized, and clinically translatable.